AANA wellness – ProCRNA

Get Fit for Duty

By Thomas Davis, CRNA, MAE, Lt. Col (ret)

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Obesity is today’s smoking. In an article published in USAToday, authors O’Donnell, Barry and Covington make the case that obesity and inactivity could outpace smoking as a cause of cancer in the upcoming decades. Further, a video accompanying the article presents evidence that childhood obesity greatly increases the probability of depression as an adult. Connecting the dots, if you are inactive and obese with an elevated risk of cancer, and if your children are also obese, their risk for adult depression greatly increases as well as their risk for cancer. Nobody would consciously wish cancer or depression upon themselves or their families and yet the bad news is that obesity with its co-morbidity is rampant in our profession and our society. The good news is that you are the one who can change the course of your personal history with three simple steps; get motivated, change your behaviors and use technology to stay on track.

Get motivated

If you’re obese, you have more than a few extra pounds to lose, a task which you may view as a daunting. Make it manageable by tuning into your thoughts becoming aware of your inner dialogue. Are you thinking I Can or I Can’t? I Hate exercise or I Can Learn Some Exercises I like? Thinking I should is not a call to action; however, thinking I will sets you up for success. Here are some tips for motivating yourself to re-claim a healthy body,

Have a reason Write down a purpose for changing your lifestyle and read it every morning and evening. Use affirming words like can and will and focus on what you know you get out of it, not what feel you’re giving up. Make it your goal to gain health and avoid focusing your attention on losing weight.
Get a buddy. Share the accountability with a friend who has a similar desire to improve his/her health. Team up, check in frequently and support one another.
Keep a Journal. Writing a daily entry in a journal helps you track your success while providing a frequent reminder of your goal and the many reasons it’s important to you.

Change your behavior

Behavior that is repeated becomes a habit. Here are some behavior changes that you can make today and when repeated daily for 8 weeks will become healthy habits.

Morning workout/stretch. Wake up your body by getting in motion in the morning. An early morning gym workout is optimal however many people don’t have the time or resources to make it happen. That’s OK but it’s not an excuse for inactivity. Develop a plan to do a short home workout, stretch and crunch every day before you start your morning routine. Check out the 7-Minute Workout..
Park at far end of lot. Every step you take counts so park where you can take the most steps. While walking in from the lot, think about why you’re doing is and what other things you can do that day to support your goal.
Take stairs. Take the stairs whenever possible. Only take the elevator if the distance is more than your legs will tolerate, in which case, take one set of stairs and then the elevator.
Drink water. Your body needs water to function properly. In addition, when you are well hydrated salt is cleared from your system which reduces water retention. Your digestion and metabolism both improve when you are well hydrated.
Eliminate sugary drinks. Sugary drinks will sabotage your wellness efforts. It only takes a few high-sugar drinks to double your calorie intake for the day and consuming them diverts you from what your body really need – water.
Bring your lunch. Control the number and quality of calories that you eat by bringing your own food. Pack a high-nutrient low-fat low-sugar lunch and do not eat anything that you do not bring with you. Avoid the temptation of making your lunch an appetizer before eating lounge food.
Ban lounge junk food. It’s not always possible to control the behavior of others however banning junk food from the lounge raises the level of awareness of your colleagues and may motivate some of them to join the new healthier you. At the very least, don’t be the one bringing the junk.

Use technology

Harness and use to digital technology to your advantage when developing a healthy lifestyle. Texting and social media connect you with friends who can offer support as you share your progress. As well, there are countless apps you can use to develop your exercise and nutrition program and track your progress. Following are ten apps as described by their advertisements.

Keas Keas is a web-based, holistic wellness program, focusing on health goals and activities. Just imagine a site where you combine social media, fun interactive games, informative quizzes, and a little bit of healthy competition between you and your peers. You can choose to focus on whatever is important to you. https://itunes.apple.com/us/app/keas/id432425118?mt=8

Fitbit Live a healthier, more active life with Fitbit, the world’s leading app for tracking all-day activity, workouts, sleep and more…track basic activity and runs on your phone or connect with one of Fitbit’s many activity trackers to get a complete picture of your health—including steps, distance, calories burned, sleep, weight, and more. https://itunes.apple.com/us/app/fitbit/id462638897?mt=8

Endomondo track all your workouts using GPS, check your stats, and reach your fitness goals. https://itunes.apple.com/us/app/endomondo/id333210180?mt=8

My fitness pal MyFitnessPal makes it easier to log your food and activity. The more you log, the more you’ll learn about your habits and how to make healthier choices. And, best of all, logging gets easier the more you do it. https://itunes.apple.com/us/app/myfitnesspal/id341232718?mt=8

Daily burn A new workout streamed to your mobile device every day. https://www.amazon.com/DailyBurn-Daily-Burn-Streaming-Workouts/dp/B00HAPXDWK

7 minuteWorkout Become your own personal trainer to lose weight and get fit with fast, simple daily workouts. 12 high intensity bodyweight exercises. 30 seconds per exercise, 10 seconds rest between exercises. https://itunes.apple.com/us/app/7-minute-workout/id650762525?mt=8

Fooducate Fooducate is a diet coach for people who want lose weight and keep it off by eating healthy, real food. Track your food, activity, sleep, hunger, and mood. https://itunes.apple.com/us/app/fooducate-nutrition-tracker/id398436747?mt=8

Map my run Track and map every run with MapMyRun and get feedback and stats to improve your performance. Discover the best running routes, save and share your favorites, and get inspired to reach new running goals. https://itunes.apple.com/us/app/map-my-run-by-under-armour/id291890420?mt=8

Shop well ShopWell lets your food do the talking. The free SHOPWELL app tells you what’s in the food you’re buying at the grocery store and offers suggestions of new foods to try that fit with your lifestyle. https://itunes.apple.com/us/app/shopwell-healthy-diet-grocery-food-scanner/id393422300?mt=8
Meditation studio Meditation Studio is the award-winning, 5-star app with over 300 guided meditations from more than 30 leading experts. Whether you want to relieve stress, ease anxiety, improve sleep, ease confidence or simply feel a bit more calm and peaceful, this app is for you. https://itunes.apple.com/us/app/meditation-studio/id1066018502?mt=8

We are an obese society, rapidly expanding. A large number of us in healthcare need to be wide awake and ready to roll as early as 6:30 a.m. and obesity is not society’s best friend. Throw out the stress and the excuses and focus on improving your health. Do something every day to support that goal, get a buddy to have some fun and share the load; adopt new behaviors two at a time until good health is a habit. Be a healthcare role-model for the respect we have for society, for our careers, for ourselves and our children.

Special thanks to Liz Sanner Davis for editing and collaboration.

Thomas Davis is a noted leader, educator, speaker and clinical anesthetist.

Join Tom and a group of leaders for the values-based leadership webinar. Click here for information.

Employee Wellness is No Joke

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Employee Wellness is No Joke

By Liz Sanner Davis. Liz is a Certified personal trainer and frequent author for procrna.com

It’s one of the biggest jokes in the lay community. Q. Where can you find the sickest people? A. In a hospital! You probably don’t think that’s funny because every day you look at people with broken arms or legs, or repeat patients who have brutally aggressive melanomas or who live with the consequences of diabetes. Their pain is not amusing. But the joke, the cynically funny part, is that the joke is really referring to the hospital employees, your physician or physician’s assistant, the chief surgeon or anesthetist, the head of HR or the department secretary, YOU. The overweight and out of shape hospital employee appears as a huge disappointment to patients who are sick and seek your help.

Two-hundred-plus years ago, extra body fat was considered to be a sign of wealth. Abbigail Adams, after all, was short and fat. In spite of her years of physical labor on the farm and having to endure significant revolutionary war shortages, Abby still “enjoyed” a majority of her years ingesting quantities of comfort food. She and others of wealth and repute often made huge contributions to society whilst making ample time, following the years of economic travails of the war, for sitting, eating and being served often, if not well.

Is that you? Are you, in spite of 40-50 hours per week on your feet, in spite of regular paychecks and good benefits, in spite of wellness issues smacking you with direct hits daily, are you fat and flabby with chronic pain that plagues you all the way to the peanut butter cups and chocolate bars in the break room? Well, then, the joke’s on you, ‘though the patient isn’t laughing.

Don’t get me wrong. Being laughed at is ok on occasion, but laughing with is a whole lot more fun, and being the laughingstock? Not fun at all. In a new society that likes to outsource responsibility for their health to the healthcare industry, what part of your health problem is theirs, and what part of the problem is yours to fix or to prevent?

One can follow the history of workplace wellness in a timeline that begins with centuries-old Asian cultures, where employers dictated the wellness rules to employees. Throughout central Europe taxpayers supported and still support mandatory month-long employee holidays, thermal baths included. In the 1800’s, westward across the pond the wealthy elite offered workplace exercise activities to other wealthy elite. George Pullman, of rail fame, was one of the first to provide for general employee onsite wellness. (http://www.marketwatch.com/story/companies-meddling-in-employee-health-since-1880-2013-04-11)

The1970’s until the present have brought gradual changes to wellness in America. We have tried to approach wellness the same way we approach politics – by keeping The Nutrition Party and the Exercise Party separate. But over the last 45+ years, we have learned that exercise coupled with nutrition equals wellness. Along the way during those 45 years, the cost of living, the cost of healthcare and, therefore, the cost of taxes has risen exponentially. Fewer people carry the large economic burden and as medical know-how improves and the need for healthcare increases, the health of over-worked, over-stressed and over-tired employees has created a greater need than ever for wellness in the workplace. Employers are stepping up.

Broward, in Ft. Lauderdale, Fla, advertises, “We are a hospital-based fitness center with professionals certified by the American College of Sports Medicine and the National Strength and Conditioning Association. Our staff includes nutritionists and personal trainers who are educated in exercise physiology and nutrition, helping you create a healthier body, inside and out.”
Employees at The Johns Hopkins, Baltimore, MD provide a wealth of options presented on a monthly calendar that guides employees to the right location whether to enjoy a walking program or a smoking cessation appointment. Incentives are offered to encourage participation and commitment, and who doesn’t love praise and free stuff?
Grant Health and Fitness Center in Columbus, Ohio promotes “…health enhancement and disease prevention.” It is associated with a vast network of area hospitals and all locations have employee-friendly hours, a no-excuses kind of offer to help you maintain your status as an employee rather than as a patient.
The Cooper Institute, Dallas, TX has associated itself with healthcare entities for decades and offers certification for employees to return to the workplace and develop wellness/fitness programs. The Cooper’s credible certification program attracts healthcare, corporate and government clients worldwide.

Providing employee wellness programs like these benefits the employer as well as the participant. Company insurance rates go down based on number of participants and proven results. Employee absenteeism is significantly reduced. People who work out together, work better together. They’re happier and, usually, just nicer to be around. And the quality of work provided by the healthy employee improves the entire company culture. Good health should reduce healthcare costs and reduced health care costs should lower our taxes!

But, be ready to pay if you want to play. Everyone wants something for free. If one thing has a fee and the other is free, we all know we will try very hard to make the freebie work, even if it really doesn’t. And if something costs nothing, the likelihood that we will follow through with the acquisition diminishes along with the return.

If wellness and fitness programs are not available at your place of work, get on it. the gym manager to your department chair. Head to Dallas to get certified at the Cooper Institute. After a rigorous week or two of classes and examinations, you could be qualified to blaze some trails to a clinic back home in Mississippi or Wyoming.

If wellness and fitness programs are available at your place of work, get to it. Join a program or help design a new one. Arrange to work with a qualified trainer. Get a work-out buddy and give and get the support that a partner provides, even and especially if you get to make a new friend doing it. For quality results, be certain to follow an integrated program that includes nutrition along with fitness. Be prepared and willing to pay the fee if it isn’t free.

So, what card will you be at work – the joke or the joker? Peanut butter and banana sandwiches may be how many of us got through college, but not through life. Take advantage of the whole-meal-deal offered by the employer at your place of work, and remember: The changes you make, the integrated health that you display to the patient, increases their trust and respect in the entire healthcare industry. Together, the patient’s trust and your good health will leave a permanent impression on history.

More:

http://www.corporatewellnessmagazine.com/worksite-wellness/the-evolution-of/http://www.bethesdaweb.com/employee-wellness-programs http://www.beckershospitalreview.com/hospital-management-administration/18-most-popular-wellness-programs-for-hospital-employees.html

http://www.fiercehealthcare.com/story/what-hospitals-are-doing-employee-wellness/2012-03-15

http://www.amnhealthcare.com/the-roi-of-hospital-employee-wellness-programs/

http://www.cooperinstitute.org/pub/class_list.cfm?course_id=303

CRNA Fitness: Circuit Training

The Circuit Train

Working out can be whole lot simpler when you know the drill! If you need one day a week to “relax your mind” while actually getting your work-out, try circuit-training. There are several good things about using an established circuit and here’s just one. You can go get a member of the training staff for a free orientation around the circuit. Reservations encouraged.

A circuit provides a moderate level work-out and consists of gym-level machines set up in a circle, a neat little rectangle or at the very least, all on the same side of the gym. If they are not grouped, it’s not a simple circuit, it’s a hairy maze. There will be one or two machines for each specific muscle group and in a well-thought-out arrangement, muscles will be grouped to keep you in order. Remember? It’s 4:30 a.m. before a 12-hour day of one heart, two gall bladders and whatever last-minute trauma is scheduled and you’re looking for a straight-forward work-out, not discombobulation. Start with shoulders and begin working your way around the circuit.

Overhead Shoulder Press and perhaps Incline Shoulder Press will be your starting place. If you’ve not had the orientation, you’ll need to read the instructions printed on one of the supporting braces of the press. Adjust the weight plates, adjust the seat front-to-back and up or down, sit with “Body Firm” posture, use an overhand grip and press the contraption overhead(or angled up and outward) until fully extended. Voila! Rest 30 seconds between one or two more “sets” or press onward.

Note: Adjusting the set-up options correctly and appropriately is tantamount to getting the most out of each exercise, but even more importantly, to remaining uninjured. Too much weight can crash back down, hunching shoulders can pinch your neck, exhaling at the wrong time can challenge your heart(and not in a good way), and failing to use your abs will arch and injure your back. Use caution and common sense. You too, Men!

Chest Press and Seated Chest Flies will be next and, once again, read the instructions, adjust all of the set-up options – front to back, seat up or down, weight plates – and be seated. When seated, your feet should be flat on the floor unless there are little angled platforms for your feet. Both of these machines are harder than you think so err on the side of caution and keep it light until you’ve found the level of exertion that challenges without causing pain.

Seated Lat Flies are the reverse of Seated Chest Flies – not to be confused with seated front flies which require elbows bent and arms to open and close like French doors – and may be part of the same machine. To work the chest, you’ll face outward; to work the back, you’ll face inward. And the Seated Lat Row, which has three set-up adjustments, should be next.

These require feet flat on the floor, not tucked behind you so you fall forward, nor extended in front so you can row your boat. You’re not in an outrigger canoe in Hawaii. You’re in the gym, darn it, at 4:30, darn it, before doing a heart, darn it…feet flat on the floor, please.

Triceps and biceps are next on the circuit. Note the work-out moving from strong shoulder exercises, to large chest and back muscles, to the smaller, but potentially so down-right gorgeous tri-bi muscles, the ones that never show in the OR but show big time on a beach…in Hawaii. You can see what’s on my mind in February! Biceps will be a standard Seated Biceps Curl and/or a Preacher Curl. I don’t get why this is called “preacher” but google says it’s because the arm position resembles someone praying. You’ll actually look like someone holding a Bible or a hymnal a whole lot more than praying, but whatever floats your boat is what you should visualize. Just do it! Remember, the key to good biceps curls and triceps curls is the anchoring of the elbow and maintaining neutral wrists. Curl is the basic motion, not the rolling and bending of the wrist to avoid effort.

Legs are next and last. Expect to do Seated – or angled supine – Adduction and Abduction as well as Seated Leg Extensions and maybe Leg Curls. You’re a lucky little guy if there is also a Seated Calf Raise and a Leg Press. A circuit is not generally meant to challenge to the extent or even in the same way as a full-blown 45-set work-out, so three leg machines are really enough. Lunges and squats are “on on your honor.” Crunches can wait.

Okay, you’re done. But if you did only one set of the circuit, take a 60-second break, not a 5-minute text conversation with your broker, and do the circuit again. People tend to monopolize equipment at the gym, especially cardio equipment, but the circuit may be popular, too. So you may just want to claim each machine in its turn and hang onto it until you’ve completed your two or three sets of each. Then when your legs are finished – and they WILL be – you can wobble in and out of the shower, hide your coif under a scrub cap, and take a non-circuitous route to the hospital without looking back.

To learn more about exercising with safe, efficient form, visit Liz at www.bdyfrm.com.

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